Conjoined Twin Separation by Apollo Hospital Chennai

Babies are such a nice way to start people. 
~ Don Herold.

And twin babies can only mean double the happiness!

Unfortunately not always! Twins, triplets, quadruplets born with congenial defects and many complications turn the joy to sorrow and worry. Congenial defects in newborns are a cause of high mortality. However with intervention of modern heath facilities and surgical procedures the figures have been contained to a large extent. Here I bring you the story of two identical ‘pygopagus twins’ from Tanzania, Africa. (Pygopagus twins are babies joined at pelvis.)

Apollo Hospital, Chennai, is all set to play a big role in bringing back the smile on the mother’s face!

The mother hails from a small village called ‘Kasumulu’ in Tanzania.

The defect probably wasn’t detected during her pregnancy as she is from rural background. This was the mother’s second delivery, her first child was born through ‘C’ section; the village hospital therefore referred her to district hospital. There, the doctors did ‘C’ section on her. They faced practical difficulties to take the children ‘male pygopagus twins’ out of the uterus as they were joined at the pelvis.

Pygopagus twins
Live born pygopagus twins are usually female in sex. Male pygopagus twins are very rare. Till now in medical literature only 30 sets of pygopagus twins have been reported. Of these 26 were female and only four were male. More than 60% of congenial twins are stillborn. Of the remaining, 35% die within a few days or months of birth due to various causes. Surgical separation is not easy job and often a challenge for doctors. Survival chances too are not high.

The doctors made the distraught mother aware of the difficulties of separating the twins. Imagine her disappointment! Foreseeing the complications of separating the twins, the doctors wisely referred her case to Mohimbili Hospital in the capital Dar es Salaam. It took three long days just to transport the mother and her babies from the district hospital to the capital by ambulance. The complications involved called for more attention and advice from health officials for further procedures to be carried out.

In Chennai, India
The brave mother didn’t loose heart. She went against all odds to provide the best for her twins, Ericana and Eludi. Apollo Hospitals Chennai is closely associated with the Tanzanian government by the Save a Childs Heart Initiative (SACHI). The babies were therefore shifted to Apollo Children’s Hospital in Chennai at four and a half months of age.

After extensive work up it was found that the babies were joined at the tail end of the spines and shared a single anus and rectum. They were also found to have a single phallus and urinary passage. The babies are now 9 months old and weigh 16 kgs. During the last five months tissue expanders have been placed in the back, buttocks and thighs so that skin flaps can be rotated to cover the large defects, which will be left after separation. They have adjusted well with their surroundings and nurses looking after them.

Separation of these babies is a complex task, which will take grueling 14 to 16 hours. It is scheduled on this 16th of December. This decision is the culmination of several months of meticulous planning. A team of 20 doctors from the specialties of neurosurgery, plastic surgery, pediatric surgery and pediatric urology will attempt the separation. The services of Dr. Edward Kiely – Pediatric Surgeon and Dr. Richard Howard – Anesthesiologist both from Great Ormond Street Hospital in London have been sought to guide and help in the safe separation.

As the high risk operation begins, the mother is waiting for a MIRACLE from God! She is looking forward to holding them separately in her arms. She is looking forward to their first birthday when they will be on their own feet. She is looking forward to bright and normal future for her sons. Please keep them in your prayers. Help her bear the burden. PRAYERS, they say, can move mountains! A successful surgery is the need now! I hope and pray that she goes back happily to her country with her two sons!

All the best to the team at Apollo Hospital, Chennai, for a SUCCESSFUL SURGERY!

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